title: Erectile dysfunction and coronary artery disease: an association of higher risk in younger men.
abstract: BACKGROUND
  The association between erectile dysfunction (ED) and coronary artery disease (CAD) has been described in various settings, but it is unclear if there is an independent interaction with age.
  
  
  OBJECTIVE
  To investigate the interaction of age in the association between ED and CAD.
  
  
  METHODS
  This case-control study was conducted among 242 patients referred for elective coronary angiography. One hundred fourteen patients with significant CAD were identified as cases and 128 controls without significant CAD. ED was evaluated by the erectile function domain of the International Index of Erectile Function (IIEF) questionnaire, determined by a score ≤ 25 points.
  
  
  METHODS
  Significant CAD was based on stenosis of 50% or greater in the diameter in at least one of the major epicardial vessels or their branches. The analysis was conducted in the whole sample and according to the age strata, controlling for the effects of cardiovascular risk factors, testosterone, and C-reactive protein. Results.  Patients had on average 58.3 ± 8.9 years. CAD and ED were associated exclusively in patients younger than 60 years (ED in 68.8% of patients with CAD vs. 46.7% of patients without CAD, P = 0.009). The association was independent of cardiovascular risk factors, testosterone and C-reactive protein (risk ratio 2.3, 95% confidence interval from 1.04 to 5.19). Severity of CAD was higher in patients younger than 60 years with ED.
  
  
  CONCLUSIONS
  Men with less than 60 years of age who report ED presented a higher risk of having chronic CAD and more severe disease diagnosed by coronary angiography.
authors.affiliation: Universidade Federal do Rio Grande do Sul-Postgraduate Studies Program in Medical Sciences, Porto Alegre, Brazil. charlesriedner@yahoo.com.br
authors.forename: Charles E
authors.initials: CE
authors.lastname: Riedner
authors.forename: Ernani L
authors.initials: EL
authors.lastname: Rhoden
authors.forename: Sandra C
authors.initials: SC
authors.lastname: Fuchs
authors.forename: Marco V
authors.initials: MV
authors.lastname: Wainstein
authors.forename: Sandro C
authors.initials: SC
authors.lastname: Gonçalves
authors.forename: Rodrigo V
authors.initials: RV
authors.lastname: Wainstein
authors.forename: Alexandre
authors.initials: A
authors.lastname: Zago
authors.forename: Fernando
authors.initials: F
authors.lastname: Bourscheit
authors.forename: Natan
authors.initials: N
authors.lastname: Katz
authors.forename: Alcides J
authors.initials: AJ
authors.lastname: Zago
authors.forename: Jorge P
authors.initials: JP
authors.lastname: Ribeiro
authors.forename: Flávio D
authors.initials: FD
authors.lastname: Fuchs
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000032:analysis; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000150:complications*; D007172:Erectile Dysfunction / Q000209:etiology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D013739:Testosterone / Q000097:blood
chemical_list: D013739:Testosterone; D002097:C-Reactive Protein